Senate backs plan to continue NH Medicaid expansion

CONCORD -- The plan to continue New Hampshire's Medicaid expansion program cleared a critical hurdle by winning strong bipartisan support in the state Senate Thursday night.

Senate Majority Leader Jeb Bradley, R-Wolfeboro, said the measure strikes a balance as it continues health care coverage for 50,000 low-income adults while imposing a first-time work requirement.

"The constant is that New Hampshire taxpayers are protected but at the same time we have significant reforms in this bill," Bradley said.

But Senate Finance Committee Chairman Gary Daniels, R-Milford, said this expansion is a big government solution and will become an expensive entitlement.

"We are putting ourselves in a box as opposed to what we could do to help these people get assistance and we are allowing the federal government to pull the strings," Daniels said.

Gov. Chris Sununu praised the Senate's passage of this measure (SB 313). The bill has become a top priority for Sununu, who prior to running for governor in 2016 was a critic of it.

"We have worked tirelessly over the past several months with our federal partners in Washington to demand increased innovation and flexibility in how our state runs (the) Medicaid program," Sununu said in a statement.

The Trump administration has to approve several waivers in this measure for it to become a reality.

The 17-7 vote sends the bill over to the Republican-led House of Representatives that has always loomed as a more challenging political venue.

Four years ago, the current program cleared a critical hurdle because the sitting House speaker cast a vote to break a tie.

Greg Moore, state director of the fiscally-conservative Americans for Prosperity New Hampshire chapter, said the work requirement is too weak.

"Moreover, this new plan is built on a foundation of misrepresentations. Proponents suggest it will require recipients to work, but then put enough exemptions in the law that few will actually be required to work," Moore said.

A candidate for Congress in the 1st District, Sanborn attacked Obamacare and unsuccessfully tried to limit its extension to two years. As amended, this bill would extend the program five years to the end of 2023.

Sanborn said it's unfair that those buying private health insurance in the individual market face rate increases of 52 percent while this expansion delivers very inexpensive health care to able-bodied adults who aren't working full-time.

"What it has done is virtually bankrupt the middle class that has to buy their own health insurance. What have we done for them? Nothing," Sanborn said.

Later in the debate Sanborn declared, "Our job is to create trampolines, not hammocks."

The Senate also rejected, 17-7, an amendment Guida offered to require all in the program be screened for illegal drug use.

By 2020, the state share of the cost for Medicaid expansion is 10 percent.

This measure would for the first time claim 5 percent of state liquor sales profits to serve as a taxpayer match for the New Hampshire Granite Care Advantage Health Care Program.

Other dollars serving as state match funds are existing reimbursements for Medicaid expansion from the premium tax on insurance companies as well as spending on a high-risk pool.

Sen. Daniel Feltes, D-Concord, had tried to convince the Senate to earmark $1.5 million in spending to support those subjected to the work requirement with services such as transportation, housing subsidies and child care.

"We all believe in work; we all believe in pathways to work," Feltes said.

Bradley said such spending was "premature" and the measure creates a six-month pilot program that uses $3 million in federal welfare dollars to support job training.